tag:blogger.com,1999:blog-2919631102243889689.post6419817486691538457..comments2015-08-02T12:42:47.133-04:00Comments on Mothers in Medicine: Rites of PassageKChttp://www.blogger.com/profile/02114277144629595998noreply@blogger.comBlogger17125tag:blogger.com,1999:blog-2919631102243889689.post-3060800435584118432011-09-03T00:30:20.904-04:002011-09-03T00:30:20.904-04:00For anyone reading this post - ACOG came out with ...For anyone reading this post - ACOG came out with new guidelines in July of 2011. They hadn&#39;t changed since 2003 (dinosaurs). Now they recommend yearly mammograms starting at 40, based on current literature.Gizabeth Shyderhttp://www.blogger.com/profile/04084807460427610182noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-14199878179623056512011-06-16T22:24:36.654-04:002011-06-16T22:24:36.654-04:00Agree. Well said. Can&#39;t empathize with older...Agree. Well said. Can&#39;t empathize with older machines, but I can imagine.Gizabeth Shyderhttp://www.blogger.com/profile/04084807460427610182noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-44362876517575897422011-06-16T19:36:31.351-04:002011-06-16T19:36:31.351-04:00Well over 50. And the machines really are lots bet...Well over 50. And the machines really are lots better. So are the techs. And yeah, it hurts, but a mastectomy looks like it hurts a lot more.mamadocnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-90522294790440606572011-06-16T17:02:47.786-04:002011-06-16T17:02:47.786-04:00They say that doctors make the worst patients - an...They say that doctors make the worst patients - and I certainly fit that rule. Haven&#39;t checked in on my own PCP and I&#39;ve had him 8 years. Haven&#39;t taken a sick day in 6 years. One of my partners sat on a stomachache all day and ended up with a ruptured appendix. I did just get the highest rating for life insurance after giving them my bodily fluids to analyze, so I guess that is a good thing.<br /><br />You will probably live longer than me. Yes, we all die of something.Gizabeth Shyderhttp://www.blogger.com/profile/04084807460427610182noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-32920956563213096732011-06-15T09:39:44.413-04:002011-06-15T09:39:44.413-04:00I did make a well-informed choice; I&#39;m followi...I did make a well-informed choice; I&#39;m following the USPSTF recommendations mentioned by MomTFH.<br /><br />I&#39;m much more concerned about cardiovascular disease than breast cancer, though I&#39;ve never been overweight and am a lifelong non-smoker. Three of my grandparents died of cardiovascular disease, though one also had Alzheimer&#39;s (can&#39;t do anything about that, AFAIK).<br /><br />My former PCP pressured me to go for mammograms starting at age 40 as well as continued annual Pap smears (despite monogamous relationship and long history of normal tests) and annual basic bloodwork (of questionable utility for a healthy person). This made me very uncomfortable as I felt her frustration with my repeated polite refusals distracted her from paying sufficient attention to what is most likely to kill me, based on both family history and overall population: cardiovascular disease. I felt like she was checking off boxes on a not-very-well-thought-out list rather than looking at me as an individual. So I dropped her. My new PCP and I agree on priorities for my routine healthcare and I listen to her recommendations. Best of all? My borderline &quot;white coat&quot; hypertension has all but disappeared since I&#39;ve switched physicians. Coincidence? I think not.<br /><br />We&#39;re all going to die of something.TJnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-42396952149100748522011-06-14T09:58:38.432-04:002011-06-14T09:58:38.432-04:00Not a fun milestone, at all. :)Not a fun milestone, at all. :)rlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-91569031247914201112011-06-14T09:07:43.180-04:002011-06-14T09:07:43.180-04:00It sounds like you have made a very well-informed ...It sounds like you have made a very well-informed choice, TJ. I really respect that. Thanks for your input.Gizabeth Shyderhttp://www.blogger.com/profile/04084807460427610182noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-38015999488930436622011-06-14T08:42:57.115-04:002011-06-14T08:42:57.115-04:00&gt;&gt;as someone who looks at hundreds of breast...&gt;&gt;as someone who looks at hundreds of breast cases a year, many of them women under 40 - I have an extra edge of paranoia that makes me happy to follow the recommendation of my OB&gt;&gt;<br /><br />Many of the samples you see, especially in very young women, are obtained after a lump is discovered and/or a diagnostic mammogram. Also, as you probably know, early discovery does not equal longer survival time, and some of the really nasty tumors (like inflammatory breast cancer) grow so quickly that annual exams frequently miss the tumor entirely at an early stage. Breast cancer, as you well know, is not just one disease, and mammography is a blunt screening instrument at best, IMO.<br /><br />Knowing all of this, and having looked at the numbers, I&#39;ll take my chances. I&#39;d refuse ultrasound and MRI, too.TJnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-65644299621977643312011-06-14T05:34:48.517-04:002011-06-14T05:34:48.517-04:00I saw one of the breast radiology specialists desc...I saw one of the breast radiology specialists describe it once, using her hands and her own breast to illustrate (through her clothing), when answering an oncologist’s question about the orientation difference between looking at a mammogram and MRI, but I still didn’t really get it.anti snorehttp://www.antisnores.comnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-1519004426643868622011-06-13T23:24:04.700-04:002011-06-13T23:24:04.700-04:00I looked them up after MomTFH&#39;s comment. Very...I looked them up after MomTFH&#39;s comment. Very stringent. Thanks for providing the link for everyone.Gizabeth Shyderhttp://www.blogger.com/profile/04084807460427610182noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-41556941075423270022011-06-13T23:18:50.221-04:002011-06-13T23:18:50.221-04:00Thanks for writing about this; so glad everything ...Thanks for writing about this; so glad everything turned out all right... and beautiful, nonetheless! <br /><br />For USPTF guidelines, &quot;stingy&quot; as they may be, see http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htmThttp://www.blogger.com/profile/00428775846608751236noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-29601947201234575652011-06-13T20:14:17.537-04:002011-06-13T20:14:17.537-04:00Thanks, RockStarMD Girl!
TJ - I know the breast r...Thanks, RockStarMD Girl!<br /><br />TJ - I know the breast radiologists at our institution and they are very good. I see the specimens. I realize that false positives can happen, but as someone who looks at hundreds of breast cases a year, many of them women under 40 - I have an extra edge of paranoia that makes me happy to follow the recommendation of my OB. The worst is when you pick up a slide, see the age - some down in 20&#39;s - and notice lactating ducts right next to Grade 3 cancers. I realize these are outliers, and many have family history, but still. <br /><br />Cardiomom - I don&#39;t know the answer on screening mammograms. I have not yet written a check. Hopefully someone else can chime in.<br /><br />Christie Critters - that sounds like a sick variation of twister!<br /><br />MomTFH - thank you! It really wasn&#39;t too bad. Good luck with your decision. Sounds like Bette and Hil all over again - made me smile.Gizabeth Shyderhttp://www.blogger.com/profile/04084807460427610182noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-91899458680068514042011-06-13T19:34:31.235-04:002011-06-13T19:34:31.235-04:00I had this same discussion when I went in for my a...I had this same discussion when I went in for my annual female exam this month. Funny, I guess this shows the difference between us. I whipped out the old USPSTF argument, and told the resident I am not a good candidate for early mammogram. <br /><br />I am 38. Non smoker, light occasional drinker. Breastfed two kids. No first degree relative (or even second degree) with breast cancer. Caucasian. Big honkin fibrous breasts.<br /><br />He walked out of the room, discussed it with a colleague, and came back in saying the USPSTF was &quot;stingy&quot; in its recommendations. I said yes, they are, and I tend to agree with them, being non-interventionist minded myself. He walked out again,and came back in with a prescription for a breast ultrasound. Sigh, I may get it.<br /><br />Anyway, I loved your description. I do think the mammograms can look beautiful, and I am sure yours looked particularly beautiful to you. You describe the experience as something more than a painful annoyance, which is the way I usually hear it remembered. Now I may get a baseline at 40.MomTFHhttp://www.momstinfoilhat.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-19255420989334477212011-06-13T17:44:21.608-04:002011-06-13T17:44:21.608-04:00My first screening was done at 35. Then there was...My first screening was done at 35. Then there was nothing again until 40. Then 45. Then 50. Then every year...<br />The first one was so uncomfortable that I almost never went back.<br /><br />Things have improved a lot in 20 years. The first machine that I remember didn&#39;t rotate and you had to contort your body (or maybe I just IMAGINED that as it was so traumatic).Christie Crittershttp://www.blogger.com/profile/17409348100826092353noreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-31833001518326296152011-06-13T17:25:16.505-04:002011-06-13T17:25:16.505-04:00had my first at 28 for a lump, turned out to be a ...had my first at 28 for a lump, turned out to be a cyst (phew!), the US was much better. The breast squishing is Not a pleasant experience. My mother in law still insists that mammograms made her breast deflate and long(er) and will not consider that this tends to happen at 70 yrs of age..anyway, another story all together).<br />Wonder if the MRI is more pleasant and if insurance will cover costs for screening - anyone know? Friend of mine just had a double mastectomy at 42, i think we need to start screeninig earlier, not later, certainly not at 50cardioMomnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-72959906620535357472011-06-13T15:45:47.324-04:002011-06-13T15:45:47.324-04:00Screening mammograms recommended below the age of ...Screening mammograms recommended below the age of 40? You have got to be kidding me. Last I heard, some recommend starting at age 40, some not until age 50.<br /><br />Personally, knowing the high rate of false positives - just like yours - especially in younger women with dense breasts, I&#39;m waiting until 50. At least.TJnoreply@blogger.comtag:blogger.com,1999:blog-2919631102243889689.post-77313549523847718702011-06-13T15:20:18.461-04:002011-06-13T15:20:18.461-04:00Every radiologist I&#39;ve met has been so nice! ...Every radiologist I&#39;ve met has been so nice! Too bad I can&#39;t sit in a dark room without falling asleep either.<br /><br />Glad it all turned out ok!Old MD Girlhttp://www.blogger.com/profile/17937425894428802591noreply@blogger.com